As surrogacy becomes a more familiar route to parenthood, for both same-sex couples and infertile heterosexual intended parents, surrogacy industry expert Sam Everingham looks at what drives parents to engage overseas, assesses the Thailand shutdown in 2014, and considers future projections.
Some US states (California and Minnesota to name just two) have been offering legal surrogacy for up to 30 years and have some of the best procedures and protections in place for both surrogates and parents. Choosing an experienced, trustworthy US surrogacy pathway has been the gold standard for those who can afford it, and brings the added bonus of US citizenship for any child born there. Unfortunately, however, many UK-intended parents simply cannot afford US legal, medical and insurance costs.
Such cost pressures along with difficulty locating a reliable surrogate at home have pushed many UK intended parents to engage in more affordable surrogacy in Thailand, India, Ukraine, Georgia and even Greek Cyprus, Nepal and Mexico.
Of these alternatives, India has perhaps the highest level of medical expertise, competition and sound surrogacy processes. Indian medical specialists all speak English – many were trained in the UK medical system.
India – Better to be Irish
For UK citizens engaging in surrogacy in India, at least one parent must remain around four months in India post-birth. However, for many other nationalities, including the Irish, their government will rapidly grant newborns travel documents allowing safe passage to their parents’ home country.
John and Caitriona are an Irish couple from County Louth who embarked on Indian surrogacy in January 2013 after over four years of failed IVF attempts on home shores. Both in their mid-forties, their local infertility support organisation had warned them that surrogacy “was not for the faint-hearted” but added that the alternative, adoption, was not only incredibly stressful but increasingly difficult to achieve.
The pair researched options in both India and Ukraine, speaking to clients of various clinics. “For me,” says John, “the most nerve-wracking part of the process was deciding to proceed – in effect placing trust and hard-earned savings in the hands of a foreign clinic.”
Ultimately, John and Caitriona settled on a New Delhi agency. “Talking to others who had been on the journey already was invaluable. We put a hefty down-payment on a ‘multi-attempt package’ before flying to India in September 2013 to meet with the surrogate we had been matched with.
“On the first embryo transfer, our surrogate fell pregnant. We could not believe our good fortune. And nine months on, we were parents to baby Luke.”
The Irish government granted Luke an Emergency Travel Certificate, allowing him to travel internationally. Within two weeks of arriving in New Delhi, John, Caitriona and their 14-day-old baby were boarding the aeroplane bound for Dublin.
However, given India does not grant citizenship to children born to foreigners via surrogacy, young Luke remains in legal limbo, without citizenship of any country.
Luckily, in the absence of any relevant Irish laws, the Department of Foreign Affairs have legal guidelines in place. Baby Luke will get citizenship, but this requires an application for a Declaration of Parentage in the Circuit Court, a lengthy and expensive process. Still, to Luke’s parents this is a small price to pay for the child they are raising.
So when the Irish Parliament made a call for submissions to assist it in drafting new laws in September 2013, John was galvanised to tell his story, and encouraged others to do the same.
“I now volunteer with Ireland’s National Infertility Support and Information Group, assisting other parents in navigating such journeys. I am one of many parents and surrogates who will be sharing their stories at FTS London conference on March 21.”
Thailand – What went wrong?
Last year, the Baby Gammy scandal on top of the Thai military’s crackdown on compensated surrogacy shone the media spotlight on surrogacy as a means to family formation. The Thai authorities were furious that compensated surrogacy had thrived under their watch, mainly because it went against not just medical council guidelines but more importantly, Thai cultural norms.
Thai surrogacy agency staff fled, terrified of reprisals by the military government. Warrants were issued for the arrest of Dr Pisit, Thailand’s most popular IVF physician amongst foreigners. Intended parents with pregnant Thai surrogates were left worried to distraction – for the safety of their surrogates and their unborn children. Some took leave from work and flew to Thailand to reassure their surrogate they would be looked after.
Major media agencies around the world went to extreme lengths to gain access to intended parents struggling to get their long-awaited infants home, and parents stuck in Bangkok with newborns ended up holed up in hotel rooms too terrified to venture out.
Some parents from European countries resorted to temporarily marrying their Thai surrogate in order to circumvent their own country’s refusal to provide citizenship for their newborns.
Families Through Surrogacy’s positioning as a non-profit consumer organisation advocating best practice meant we were called on dozens of times by international media for comment on the implications of this mess. Suddenly the organisation found itself the conduit between intended parents, government and media.
What no media understood or reported on was how a major industry had been able to develop without Thai government approval. Not one Thai IVF doctor had talked publicly about surrogacy. Therefore, how had thousands of intended parents found their way to Thailand with no paid advertising of the services available? The answer lay in social media – consumers taking information-seeking and decision-making to a grassroots level – connecting with intended parents online via Facebook groups and blogs, many of them run by Thai agents and surrogacy clinics.
The key desire is for word-of-mouth recommendation – what lawyer is good in this area and doesn’t overcharge? How do I find an egg donor? What guarantees are there medically?
In the fall-out, most of these agents and surrogacy agencies turned their backs on Thailand, asking clients to start again in new destinations such as Mexico and Nepal.
Last year’s dramas highlight not only the risks hopeful parents take in engaging in surrogacy in unregulated markets, but the speed at which new options appear when another closes down.
The Nepalese government quietly passed surrogacy legislation to give legal recognition of intended parents – whether gay or heterosexual. Already three operators have on-the ground staff and support services in the Nepalese capital.
Informed local sources say Mexico will soon be ‘like Thailand’ because unethical operators have moved in, introducing illegal practices to cope with rising demand.
Mexican Congresswoman Liliana Madrigal has proposed changes to make surrogacy available only to residents of the single Mexican state which allows it. Her bill also proposes restricting availability to heterosexual couples and outlawing surrogacy contracts. Changes in Mexico may be applied as early as February 2015, potentially blocking new international clients from engaging in Mexico.
Surrogacy agencies in Mexico remain philosophical though most appreciate they may only have a limited window of opportunity to assist international intended parents. Even if Tabasco law changes, international precedent strongly suggests that existing surrogacy contracts will be honoured. Changes cannot be retrospective without risking the future of many unborn children.
To those caught up in the confusion, the year was stressful, but emphasised the importance of education, communication and connection in a largely unregulated area. The Foreign and Commonwealth Office (FCO) are in the early stages of planning an advice campaign aimed at Brits considering a surrogacy arrangement overseas.
Certainly one outcome of recent events has been greater enthusiasm amongst intended parents to locate a surrogate at home, even if that means travelling to Greece or elsewhere in Europe for the IVF component to save on costs.
Entrepreneurial agencies are already planning new operations in countries with willing governments, including Greek Cyprus, Greece and Cambodia.
Meanwhile, the consumer non-profit Families Through Surrogacy has grown from nothing to over a thousand members in the space of a year. They held their first UK/EU conference in March 2014 with little PR budget, yet the conference committee were taken aback at the numbers who attended – surrogates, parents, children through surrogacy and hopeful parents from around the UK and mainland Europe.
Attendee feedback showed the popularity was due to the focus on consumers sharing their own journeys as surrogates or intended parents. Those considering something as significant as surrogacy take so much out of getting to know other singles and couples who have gone before them.